Airway

COPD exacerbation and CPAP

Chronic obstructive pulmonary disease flares show up as increased work of breathing—prolonged exhalation, pursed-lip breathing, accessory muscle use—often with hypoxia on pulse oximetry. EMTs do not withhold oxygen in difficulty breathing because of COPD history; treat the patient in front of you and follow protocol.

When the patient is conscious, alert, and still ventilating (not in respiratory failure ), continuous positive airway pressure (CPAP) can reduce work of breathing during transport where authorized. Blow-by or passive oxygen alone may not match the ventilatory demand; bag-valve-mask ventilation is reserved for inadequate rate or tidal volume.